This paper argues in favor of the epistemic properties of inclusiveness in the context of democratic deliberative assemblies and derives the implications of this argument in terms of the epistemically superior mode of selection of representatives. The paper makes the general case that, all other things being equal and under some reasonable assumptions, more is smarter. When applied to deliberative assemblies of representatives, where there is an upper limit to the number of people that can be included in the group, (...) the argument translates into a defense of a specific selection mode of participants: random selection. (shrink)

I aim to explain why majority voting can be assumed to have an epistemic edge over lottery voting. This would provide support for majority voting as the appropriate decision mechanism for deliberative epistemic accounts of democracy. To argue my point, I first recall the usual arguments for majority voting: maximal decisiveness, fairness as anonymity, and minimal decisiveness. I then show how these arguments are over inclusive as they also support lottery voting. I then present a framework to measure accuracy so (...) as to compare the two decision mechanisms. I go over four arguments for lottery voting and three arguments for majority voting that support their respective accuracy. Lottery voting is then shown to have, compared to majority voting, a decreased probability of discrimination. That is, I argue that with lottery voting it is less probable under conditions of normal politics that if the procedure selects X, X is reasonable. I then provide two case scenarios for each voting mechanism that illustrate my point. (shrink)

Fairness is a central, but under-theorized, notion in moral and political philosophy. This paper makes two contributions. Firstly, it criticizes Broome’s seminal account of fairness in Proc Aristotelian Soc 91:87–101, showing that there are problems with restricting fairness to a matter of relative satisfaction and holding that it does not itself require the satisfaction of the claims in question. Secondly, it considers the justification of lotteries to resolve cases of ties between competing claims, which Broome claims as support for his (...) theory, and contrasts random procedures to contests of skill, which may also be considered lotteries in a broader sense. I offer no alternative account of fairness of my own, but hope to point the way for future research on the nature of fairness. (shrink)

I defend a weak version of the Pigou-Dalton principle for chances. The principle says that it is better to increase the survival chance of a person who is more likely to die rather than a person who is less likely to die, assuming that the two people do not differ in any other morally relevant respect. The principle justifies plausible moral judgements that standard ex post views, such as prioritarianism and rank-dependent egalitarianism, cannot accommodate. However, the principle can be justified (...) by the same reasoning that has recently been used to defend the core axiom of ex post prioritarianism and egalitarianism, namely, Pigou-Dalton for well-being. The arguably biggest challenge for proponents of Pigou-Dalton for chances is that it violates State Dominance for social prospects. However, I argue that we have independent reason for rejecting State Dominance for social prospects, since it prevents a social planner from properly respecting people's preferences. (shrink)

Many philosophers think that we should use a lottery to decide who gets a good to which two persons have an equal claim but which only one person can get. Some philosophers think that we should save identified persons from harm even at the expense of saving a somewhat greater number of statistical persons from the same harm. I defend a principled way of justifying both judgements, namely, by appealing to the decreasing marginal moral value of survival chances. I identify (...) four desiderata that, I contend, any such justification should satisfy, and explain how my account meets these desiderata, unlike some previous accounts. (shrink)

Why should a lottery be used in the allocation of an indivisible good to which participants in the lottery have an equally strong claim? Stone argues that when indeterminacy arises, in which it is impossible to satisfy the equality condition requiring like cases to be treated alike, the impartiality principle suggests that the agent responsible for the allocation task should not intend to favor one over another on the basis of invalid reasons. In this article, I argue that the impartiality (...) principle is neither sufficient nor necessary to explain the fairness of lotteries. Instead, the fairness of lotteries is explained by the sanitizing effect that lotteries generate to screen out the reactive attitudes of resentment and indignation that claimants might otherwise have if they do not obtain the good in question. (shrink)

Democratic alternation in power involves uncontrolled policy experiments. One party is elected on one policy platform that it then implements. Things may go well or badly. When another party is elected in its place, it implements a different policy. In imposing policies on the whole community, parties in effect conduct non-randomized trials without control groups. In this paper, we endorse the general idea of policy experimentation but we also argue that it can be done better by deploying in policymaking randomized (...) controlled trials. We focus primarily on the democratic benefits of using randomized trials in policymaking and on how they can enhance the democratic legitimacy of policy. We argue that randomized trials resonate well with three key democratic principles: non-arbitrariness, revisability and public justification. Randomized trials’ contribution to non-arbitrariness and revisability is not unique; other types of evidence can advance these democratic principles as well. But through their peculiar democratic scrutability, randomized trials are well-equipped to contribute to the public justifiability of policy. (shrink)

Two recent collections of papers—Social Equality: On What It Means to Be Equals, edited by Carina Fourie, Fabian Schuppert, and Ivo Wallimann-Helmer and The Equal Society: Essays on Equality in Theory and Practice, edited by George Hull —demonstrate well the wide diversity of perspectives on egalitarianism within political theory today. But there are unifying themes amidst all this diversity. In particular, these collections make plain the extent to which contemporary egalitarianism in all forms is indebted to Rawls. This debt is (...) reflected, for example, in the luck egalitarianism/social egalitarian debate which plays a central role in both books. It is also reflected in the concern so many contemporary egalitarians have for respect and its social basis. But while egalitarianism today owes much to Rawls, this does not mean that Rawls has nothing left to contribute to the conversation. This essay will argue that a return to Rawls can help contemporary egalitarians avoid taking their debates in certain unproductive directions. (shrink)

In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims (...) to these resources rather than use RAND to allocate such resources. (shrink)

Los procesos democráticos de toma de decisiones pueden ser evaluados por sus resultados, por su valor intrínseco o por una combinación de ambas cosas. Mostraré que analizar a fondo estas alternativas permite sacar a la luz las debilidades más serias en los modos usuales de justificación del constitucionalismo. La fundamentación teórica de la articulación entre democracia y constitucionalismo ha permanecido atrapada en una trampa que busco romper. Concluiré mostrando la necesidad de rebasar los argumentos epistémicos y contra-epistémicos sugiriendo pautas que (...) hasta ahora creo han sido poco ponderadas en la literatura clásica sobre el tema. (shrink)

Since field experiments in democratic politics influence citizens and the relationships among citizens, they are freighted with normative significance. Yet the distinctively democratic concerns that bear upon such field experiments have not yet been systematically examined. In this paper, we taxonomize such democratic concerns. Our goal is not to justify any of them, but rather to reveal their basic structure, so that they can be scrutinized at further length. We argue that field experiments could be democratically objectionable even if they (...) are not decisive – even if they do not swing the results of elections or other political decisions. Rather, if a class of campaign experiments is objectionable, one reason for this is that they undermine citizens’ equal standing. The ideal of equal standing affords nuanced judgments about the permissibility of field experiments in democratic politics. (shrink)

One rationale policy-makers sometimes give for declining to fund a service or intervention is on the grounds that it would be ‘unaffordable’, which is to say, that the total cost of providing the service or intervention for all eligible recipients would exceed the budget limit. But does the mere fact that a service or intervention is unaffordable present a reason not to fund it? Thus far, the philosophical literature has remained largely silent on this issue. However, in this article, we (...) consider this kind of thinking in depth. Albeit with certain important caveats, we argue that the use of affordability criteria in matters of public financing commits what Parfit might have called a ‘mistake in moral mathematics’. First, it fails to abide by what we term a principle of ‘non-perfectionism’ in moral action: the mere fact that it is practically impossible for you to do all the good that you have reason to do does not present a reason not to do whatever good you can do. And second, when used as a means of arbitrating between which services to fund, affordability criteria can lead to a kind of ‘numerical discrimination’. Various attendant issues around fairness and lotteries are also discussed. (shrink)

In the event of a pandemic, demand for vaccines may exceed supply. One proposal for allocating vaccines is to use a lottery, to give all citizens an equal chance, either of getting the vaccine or of surviving. However, insistence on strict equality can result in seriously suboptimal outcomes. I argue that the requirement to treat all citizens impartially need not be interpreted to require equal chances, particularly where citizens are differently situated. Assuming that we want to save lives, we should (...) also seek to use vaccine efficiently, so far as this is compatible with equality. Thus, in allocating vaccine, we may want to be sensitive to different levels of need and/or effects on vaccine production. While such policies may result in unequal chances, they may even improve everyone’s chances. In such cases, the resultant inequality is not a violation of impartiality, but a consequence of considering each person’s claim seriously. (shrink)

Public health decisions made by the state involve considerable disagreements on the course of actions, uncertainties, and compromises that arise from moral tensions between the demands of civil liberties and the goals of public health. With such complex decisions, it can be extremely difficult to arrive at and justify the best option. In this article, we propose an ethical decision-making framework based on the philosophy of Ubuntu and argue that in sub-Saharan African settings, this approach provides attractive alternative conventions of (...) moral decision-making and a useful language for understanding moral reasoning and ethics. Through its emphasis on humanity, compassion, and social responsibility, Ubuntu (“I am because we are”) has the potential to facilitate solutions to and avert conflicts between individual rights and public health. The use of Ubuntu shifts the moral reasoning and ethics of decision-making from a field of philosophy shaped by the global north, to the everyday values, decision-making, and consequent practices of people in much of Africa. Using examples of Ebola, pandemic influenza, and tuberculosis, we illustrate how Ubuntu can be applied to tackle conflicting ethical problems in public health and medicine. (shrink)

This article compares the ‘enfranchisement lottery’, a novel method for allocating the right to vote, with universal suffrage. The comparison is conducted exclusively on the basis of the expected consequences of the two systems. Each scheme seems to have a relative advantage. On the one hand, the enfranchisement lottery would create a better informed electorate and thus improve the quality of electoral outcomes. On the other hand, universal suffrage is more likely to ensure that elections are seen to be fair, (...) which is important for political stability. This article concludes that, on balance, universal suffrage is prima facie superior to the enfranchisement lottery. Yet the analysis shows that the instrumental case for the ‘one person, one vote’ principle is less conclusive than democratic theorists usually suppose. (shrink)

Did the impartiality of clinical trials play any role in their acceptance as regulatory standards for the safety and efficacy of drugs? According to the standard account of early British trials in the 1930s and 1940s, their impartiality was just rhetorical: the public demanded fair tests and statistical devices such as randomization created an appearance of neutrality. In fact, the design of the experiment was difficult to understand and the British authorities took advantage of it to promote their own particular (...) interests. I claim that this account is based on a poorly defined concept of experimental fairness . I present an alternative approach in which a test would be impartial if it incorporates warrants of non-manipulability. With this concept, I reconstruct the history of British trials showing that they were indeed fair and this fairness played a role in their acceptance as regulatory yardsticks. (shrink)

The three most common responses to Taurek’s ‘numbers problem’ are saving the greater number, equal chance lotteries and weighted lotteries. Weighted lotteries have perhaps received the least support, having been criticized by Scanlon What We Owe to Each Other ( 1998 ) and Hirose ‘Fairness in Life and Death Cases’ ( 2007 ). This article considers these objections in turn, and argues that they do not succeed in refuting the fairness of a weighted lottery, which remains a potential solution to (...) cases of conflict. Moreover, it shows how these responses actually lead to a new argument for weighted lotteries, appealing to fairness and Pareto-optimality. (shrink)

Background: Existing ethical guidelines recommend that, all else equal, past receipt of a medical resource (e.g. a scarce organ) should not be considered in current allocation decisions (e.g. a repeat transplantation).DiscussionOne stated reason for this ethical consensus is that formal theories of ethics and justice do not persuasively accept or reject repeated access to the same medical resources. Another is that restricting attention to past receipt of a particular medical resource seems arbitrary: why couldn't one just as well, it is (...) argued, consider receipt of other goods such as income or education? In consequence, simple allocation by lottery or first-come-first-served without consideration of any past receipt is thought to best afford equal opportunity, conditional on equal medical need. There are three issues with this view that need to be addressed. First, public views and patient preferences are less ambiguous than formal theories of ethics. Empirical work shows strong preferences for fairness in health care that have not been taken into account: repeated accessto resources has been perceived as unfair. Second, while difficult to consider receipt of many other prior resources including non-medical resources, this should not be used a motive for ignoring the receipt of any and all goods including the focal resource in question. Third, when all claimants to a scarce resource are equally deserving, then use of random allocation seems warranted. However, the converse is not true: mere use of a randomizer does not by itself make the merits of all claimants equal.SummaryMy conclusion is that not ignoring prior receipt of the same medical resource, and prioritizing those who have not previously had access to the medical resource in question, may be perceived as fairer and more equitable by society. (shrink)

When there are equally strong claimants for a scarce good, lotteries are often argued to be a fair method of allocation. This paper reproduces four of the views on the fairness of lotteries that have been presented in the literature: the distributive view; the preference view; the actual consent view; and the expressive view. It argues that these four views cannot offer plausible explanations for the fairness of lotteries. The distributive view is argued to be inadequate because, even though receiving (...) expectations to a good is of value to the participants, this value cannot plausibly make a contribution to the satisfaction of a participant’s claim. Both the preference and actual consent views are argued to be implausible because they lead to accepting procedures as legitimate that fail to correspond with what a claim is. Finally, it is contended that the expressive view identifies a value that is relevant to respecting equal claimants, but that cannot plausibly be related to a procedure’s fairness. The paper concludes by maintaining that an equal treatment view can accept all the valid insights from these four views without needing to accept their untenable implications. (shrink)

Human behaviour, like everything else, has causes. Most of the time, those causes can be described as reasons. Human beings perform actions because they have reasons for performing them. They are capable of surveying the options available and then selecting one based upon those reasons. But invariably occasions arise in which the reasons known to the agent fail to single out a determinate option. When reasons cannot determine the option to select on their own, the agent must resort to some (...) form of non-reasoned decision-making. This paper distinguishes four different forms of NRDM – picking, randomizing, deferring and judging. Each form may be appropriate under different circumstances. The paper concludes by laying out the theoretical assumptions upon which this account of NRDM rests. (shrink)

In this article I present a theory of what it is to be fair. I take my cue from Broome’s well known 1990 account of fairness. Broome’s basic thesis is that fairness is the proportional satisfaction of claims, and with this I am in at least partial agreement. But neither Broome nor anyone else (so far as I know) has laid down a theory of precisely what one must do in order to be fair. The theory offered here does just (...) this. (shrink)

One important ethical issue in randomised controlled trials is randomisation. Relatively little is known about how participating individuals and communities understand and perceive central aspects of randomisation such as equality, fairness, transparency and accountability in community-based trials. The aim of this study was to understand and explore study communities’ perspectives of the randomisation process in a cluster RCT in rural Zambia studying the effectiveness of different support packages for adolescent girls on early childbearing. In this explorative study, in-depth semi-structured interviews (...) were carried out in 2018 with 14 individuals who took part in the randomisation process of the Research Initiative to Support the Empowerment of Girls project in 2016 and two traditional leaders. Two of the districts where the trial is implemented were purposively selected. Interviews were audio recorded and fully transcribed. Data were analysed by coding and describing emergent themes. The understanding of the randomisation process varied. Some respondents understood that randomisation was conducted for research purposes, but most of them did not. They had trouble distinguishing research and aid. Generally, respondents perceived the randomisation process as transparent and fair. However, people thought that there should not have been a “lottery” because they wanted all schools to receive equal or balanced benefits of the interventions. Randomisation was misunderstood by most respondents. Perceived procedural fairness was easier to realize than substantive fairness. Researchers working on Cluster Randomised Controlled Trials should consider carefully how to explain randomisation. (shrink)